Build a denial Pareto before choosing fixes
Use Pareto analysis to select the denial reason family most worth operational improvement effort.
A claims team has 1,240 denials from the last 30 days and can only sponsor one improvement project this month. Pareto analysis: rank denial categories by impact, then choose the few causes driving most rework. The common trap is choosing the denial reason people complain about most instead of ranking by avoidable operational impact. Pick the impact measure Use avoidable manual touches as the primary measure, with dollars as a secondary check. The team wants to reduce rework, so touch volume is more decision-relevant than raw denial count alone. Group like reasons Combine related no-auth codes, COB pends, duplicate claim…
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